Organization
HINES GOOD SAMARITAN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARETTA LOUISE HINES (ADMINISTRATOR)
(336) 995-4563
Entity
Organization
Contact information
Practice address
2219 MANCHESTER ST., WINSTON-SALEM, NC 27105
(336) 995-4563
(336) 607-4737
Mailing address
2219 MANCHESTER ST, WINSTON SALEM, NC 27105-5535
(336) 607-4737
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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